Delayed Onset of Lactation and Accompanying Perinatal Factors in Mothers Who Delivered at the End of A Normal Term Pregnancy

ABSTRACT Objective: This study aimed to investigate the frequency of delayed onset of lactation and accompanying perinatal factors in mothers who gave birth after a normal gestational course without any health problems. Methods: The study sample consisted of infants and their mothers who had given birth at Şanlıurfa Şan Med Hospital and then applied to the Pediatrics Health and Diseases Polyclinic for health check-ups within 3-15 days postpartum between June 2017 and September 2017. The data were analyzed with IBM SPSS Statistics 22.0. Results: Delayed lactation was reported by 30.6% of mothers, being more common among primiparous mothers and those who delivered by cesarean section (p<0.001 and p=0.044, respectively). The rate of delayed lactation was lower among those who had skin-to-skin contact than those who did not (p=0.010), and among those who started breastfeeding in the first hour than those who did not (p<0.001). The rate of delayed lactation was higher if water or food other than breast milk was given on the first day or in the following period (p<0.001). Conclusion: To reduce the risk of delayed lactation, there is a need for more personalized breastfeeding counseling and interventions for mothers who have given birth for the first time. Skin-to-skin contact should be ensured in all deliveries, and unnecessary cesarean deliveries and prelacteal feeding should be avoided. Keywords: Breastfeeding, cesarean section, delayed lactatio

Breast Refusal and Maternal and Perinatal Risk Factors in the Newborn Period From a Single Center in Şanlıurfa

The many benefits of breastfeeding for both the mother and infant are well known. Therefore, the conditions that influence breastfeeding are important. Therefore, we investigated the frequency of breast refusal in the newborn period and the associated maternal perinatal risk factors at an Şan Med Hospital in Şanlurfa. A total of 407 mother-infant pairs fulfilling the study’s inclusion criteria were enrolled. The percentage of breast refusal in infants was higher in young maternal and paternal age (<25 years), being the first child, and active or passive smoking exposure of the mother during pregnancy. The percentage of breast rejection was lower when the baby started to be breastfed within the first hour of birth. The percentages of infants experiencing breast rejection were found to be significantly higher in the absence of skin-to-skin contact following delivery and in the presence of prelactal feeding at the first 3 days than in their counterparts. The rate of breast rejection was found to be higher in infants fed with mixed or formula compared with infants fed only breast milk during the last 24 h. Multiple logistic regression analysis determined that the risk of breast rejection was higher in maternal smoking/exposure during pregnancy [adjusted odds ratio (aOR): 3.19, 95% confidence interval (CI): 1.01-10.06] and delayed initiation of breastfeeding after the first hour (aOR: 3.45, 95% CI: 1.09-11.0). Being in a smoke-free environment for pregnant women should be supported by an indoor smoking ban, and early initiation of breastfeeding in the first hour after birth should be encouraged

Mineral element uptake status of endemic Isoetes anatolica Prada & Rolleri populations from Bolu-Turkey

Isoetes genus is commonly known as the "quillworts" and considered to be "fern allies". There are about 200-250 species, with a cosmopolitan distribution but often scarce to rare. Isoetes genus members often grow in extremely sensitive aquatic environments such as temporary ponds, streams and lakes. They are therefore good indicators of environmental quality. Isoetes anatolica Prada & Rolleri is an endemic plant grows on calcareous sediment/soil on the edges of seasonal ponds located in a mountainous area near the southern coast of the Black Sea at 1400 m above sea level at Bolu, Turkey. In this study, mineral element uptake statuses of I. anatolica populations were studied on the background of plant-sediment/soil-water interactions. The study materials were collected from the place where this narrow endemic species only lives in the world (Abant Region, Bolu/Turkey) by using standard methods and plant and sediment/soil mineral element measurements (Al, B, Ca, Cu, Fe, K, Mg, Mn, Na, Ni and Zn) were done. ICP-OES was employed for the measurements during the study. Interrelations between mineral element contents in the sediment/soil, water and plant were discussed. The data revealed that I. anatolica is capable of accumulating considerable amounts of certain mineral elements (B, Ca, Mn and Na).Marmara University, Commission of Scientific Research Project (FEN-D-040712-0291

COMPUTER AIDED LIP READING TRAINING TOOL

ABSTRACT Worldwide auditory-verbal education is becoming widespread for deaf children. But many prelingually, late-diagnosed deaf children and adults may utilize neither hearing aids nor cochlear implants and needed the support of lip-reading. Therefore, lip-reading skill remains to be important for oral education programmes of hearing impaired. The computerized lip-reading system which will be accomplished in this project is called &quot;AURIS&quot;. This project is designed for hearing impaired children with hearing aids or cochlear implants, aims to teach lip reading, by using characteristics of a word and will not be presented on its own but within a sentence

Morphologically different hydroxyapatite nanoparticles exert differential genotoxic effects in Drosophila

Altres ajuts: acords transformatius de la UABHydroxyapatite (HAP) occurs naturally in sedimentary and metamorphic rocks and constitutes the hard structures in many organisms. Since synthetic nano-sized HAP (HAP-NPs) are used in orthopedic applications and for heavy metal remediation in aquatic and terrestrial media, both environment and humans are exposed to them. Due to the concerns about their potential hazards, the genotoxic effects that round/rod forms of HAP-NPs were investigated in Drosophila using the wing-spot and the comet assays. Furthermore, caspase activities were evaluated to examine the activation of cell death pathways. As a novelty, the expression of 36 genes involved in DNA repair was investigated, as a tool to indirectly determine DNA damage induction. Obtained sizes were 35-60 nm (roundHAP-NPs) and 45-90 nm (rodHAP-NPs) with a low Zeta-potential (-1.65 and 0.37 mV, respectively). Genotoxicity was detected in the wing-spot (round form), and in the comet assay (round and rod-like HA-NPs). In addition, increased expression of Caspases 3/7, 8, and 9 activities were observed. For both HAP forms, increased changes in the expression were observed for mismatch repair genes, while decreased expression was observed for genes involved in ATM, ATR, and cell cycle pathways. The observed changes in the repair pathways would reinforce the view that HAP-NPs have genotoxic potential, although more markedly in the round form. Thus, the environmental presence of engineered nanoparticles, including HAPs, raises concerns about potential effects on human health. It is essential that the effects of their use are carefully assessed and monitored to ensure safety and to mitigate any potential adverse effects

Behavioral toxicity evaluation of MgO nanoparticles on drosophila melanogaster

Günümüzde nanopartiküllerin üstün fizikokimyasal özelliklerinin belirlenmesinden sonra nanopartiküller ve nanoteknolojiye olan ilgi de hızlı bir şekilde artmış ve kullanım alanları da yaygınlaşmıştır. Üç fiziksel boyutundan en az biri 1-100 nm aralığında olan ve belirli nano-ölçekli özellikler gösterebilen maddeler olarak tanımlanan nanopartiküller, tıp, elektronik, kozmetik, çevresel temizlik gibi birçok farklı alanda yaygın kullanım alanına sahiptir. Bu yaygın kullanımdan dolayı insanların da nanopartiküllere olan maruziyeti gün geçtikçe artmaktadır. Ayrıca nanopartiküllerin çevreye yayılması doğada ki birçok canlı için risk oluşturmaktadır. Bu sebeple de nanopartiküllerin yol açabileceği olumlu/olumsuz biyolojik etkilerin anlaşılabilmesi için yapılan çalışmalar da hız kazanmıştır. Bu bağlamda yapılan çalışmada MgO nanopartiküllerinin farklı konsantrasyonlarının (2, 5 ve 10 mM) Drosophila melanogaster üzerindeki davranışsal toksisiteye etkisinin araştırılması amaçlanmıştır. Davranışsal toksisitenin belirlenmesinde larval ağırlık ve hareketi, ergin birey ağırlığı, pupa oluşturma başarısı, pupa pozisyonu, pupadan çıkış başarısı, negatif jeotaksis ve ömür uzunluğu deneyleri gerçekleştirilerek değerlendirilmiştir. Çalışma sonucunda MgO NP’lerinin genel olarak Drosophila melanogaster’da negatif bir etkiye neden olduğu tespit edilmiştir. Larval hareketin incelendiği deney kapsamında çalışma kapsamında en yüksek doz olarak belirlenen 10 mM’lık derişimin istatistiksel olarak anlamlı bir şekilde azalmaya neden olduğu tespit edilmiştir.Nowadays, after the determination of the superior physicochemical properties of nanoparticles, interest in nanoparticles and nanotechnology has increased rapidly and their usage areas have become widespread. Nanoparticles, which are defined as substances that have at least one of their three physical dimensions in the range of 1-100 nm and can show certain nanoscale properties, have a widespread use in many different fields such as medicine, electronics, cosmetics, environmental cleaning. Due to this widespread use, the exposure of humans to nanoparticles is increasing day by day. In addition, the spread of nanoparticles into the environment poses a risk to many living things in nature. For this reason, studies to understand the positive / negative biological effects that nanoparticles can cause have also gained momentum. In this context, it was aimed to investigate the effect of different concentrations of MgO nanoparticles (2, 5 and 10 mM) on behavioral toxicity on Drosophila melanogaster. In determining behavioral toxicity, larval weight and movement, adult weight, pupa formation success, pupal position, exit success, negative geotaxis and longevity tests were performed and evaluated. As a result of the study, it was determined that MgO NPs generally cause a negative effect on Drosophila melanogaster. Within the scope of the experiment in which the larval movement was examined, it was determined that the concentration of 10 mM, which was determined as the highest dose within the scope of the study, caused a statistically significant decrease

The real-life efficacy of the second line treatment strategy in advanced pancreas cancer

ABS TRACT Objective: Pancreatic cancer is one of the leading causes of cancer-related death. Despite the introduction of new therapeutic agents, survival rates remain low. Furthermore, few trials have evaluated the options for second-line therapy and the prognostic variables. In this study, we aimed to determine the real-world efficacy and prognostic parameters of second-line treatment for advanced pancreatic cancer. Material and Methods: Patients with advanced pancreatic cancer from different centers who received second-line treatment were enrolled in the study. The patients’ demographic, clinical, and pathological characteristics were retrieved retrospectively. Results: A total of 161 patients were enrolled in the study. The majority of the patients (50.3%) received oxaliplatin plus fluoropyrimidine as second-line treatment. The median progression-free survival and overall survival for the entire cohort were 2.5 months and 4.5 months, respectively. In univariate anal-yses, an Eastern Cooperative Oncology Group performance status ≥2, age ≥65 years, hypoalbuminemia, thrombocytosis, presence of metastatic peritoneal disease, elevated alkaline phosphatase and carcinoembryonic antigen levels, and a neutrophil-lymphocyte ratio (NLR) ≥3 were identified as poor prognostic factors. In multivariable analyses, low albumin level (p=0.031) and high NLR (p=0.05) were found to be independent prognostic factors for overall survival. Conclusion: Pancreatic cancer is a unique malignancy, and advanced disease has a dismal prog-nosis. In univariate analyses, we identified multiple factors that were poor prognostic variables. In particular, the albumin level and NLR were independent prognostic factors for overall survival, and these parameters might be useful in selecting the second-line treatment and pre-dicting the survival of these patients

Predictive factor for lymph node metastasis in non-metastatic colorectal adenocarcinomas

Objectives: To evaluate the predictive factors of lymph node involvement in non-metastatic colorectal adenocarcinomas (nmCRC). Methods: A total of 453 patients diagnosed with nmCRC were analyzed regarding T stage, lymphovascular invasion status, tumor grade and proposed risk score (RS), determined by the combination of these three factors for lymph node metastasis. Results: The median age was 62 (25-90 years), M/F ratio was 1.4:1 and majority of the patients had tumors localized on the left colon (70.6%). The number of excised lymph nodes was ≥12 in 77% of the cases. The postoperative pathological assessments revealed that 57.2% of patie,nts had N0 disease, 29.1% had N1 disease, and 13.7% had N2 disease. The T stages (p=0.007), grade (p<0.001), lymphovascular invasion (p=0.002), RS (p<0.001), and number of excised lymph nodes (p=0.029) were significantly different between N0, N1, and N2 patients. Higher RS was associated with lymph node metastasis (p<0.001). Conclusion: The risk score may predict lymph node metastasis in patients with nmCRC and if validated may be helpful in the decision-making of adjuvant chemotherapy, especially in the elderly and patients with inadequate lymph node dissection

Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL

Diagnosis of comorbid migraine without aura in patients with idiopathic/genetic epilepsy based on the gray zone approach to the International Classification of Headache Disorders 3 criteria

BackgroundMigraine without aura (MwoA) is a very frequent and remarkable comorbidity in patients with idiopathic/genetic epilepsy (I/GE). Frequently in clinical practice, diagnosis of MwoA may be challenging despite the guidance of current diagnostic criteria of the International Classification of Headache Disorders 3 (ICHD-3). In this study, we aimed to disclose the diagnostic gaps in the diagnosis of comorbid MwoA, using a zone concept, in patients with I/GEs with headaches who were diagnosed by an experienced headache expert.MethodsIn this multicenter study including 809 consecutive patients with a diagnosis of I/GE with or without headache, 163 patients who were diagnosed by an experienced headache expert as having a comorbid MwoA were reevaluated. Eligible patients were divided into three subgroups, namely, full diagnosis, zone I, and zone II according to their status of fulfilling the ICHD-3 criteria. A Classification and Regression Tree (CART) analysis was performed to bring out the meaningful predictors when evaluating patients with I/GEs for MwoA comorbidity, using the variables that were significant in the univariate analysis.ResultsLonger headache duration (&lt;4 h) followed by throbbing pain, higher visual analog scale (VAS) scores, increase of pain by physical activity, nausea/vomiting, and photophobia and/or phonophobia are the main distinguishing clinical characteristics of comorbid MwoA in patients with I/GE, for being classified in the full diagnosis group. Despite being not a part of the main ICHD-3 criteria, the presence of associated symptoms mainly osmophobia and also vertigo/dizziness had the distinguishing capability of being classified into zone subgroups. The most common epilepsy syndromes fulfilling full diagnosis criteria (n = 62) in the CART analysis were 48.39% Juvenile myoclonic epilepsy followed by 25.81% epilepsy with generalized tonic-clonic seizures alone.ConclusionLonger headache duration, throbbing pain, increase of pain by physical activity, photophobia and/or phonophobia, presence of vertigo/dizziness, osmophobia, and higher VAS scores are the main supportive associated factors when applying the ICHD-3 criteria for the comorbid MwoA diagnosis in patients with I/GEs. Evaluating these characteristics could be helpful to close the diagnostic gaps in everyday clinical practice and fasten the diagnostic process of comorbid MwoA in patients with I/GEs